Is Coronary Artery Calcification Associated with Vertebral Bone Density in Nondialyzed Chronic Kidney Disease Patients?

Filgueira, Agostinho; Carvalho, Aluízio Barbosa de; Tomiyama, Cristiane; Higa, Andrea; Rochitte, Carlos Eduardo; Santos, Raul D.; Canziani, María Eugênia Fernandes

doi:10.2215/cjn.10061110

Cited by 20 publications

(16 citation statements)

References 34 publications

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“…This adds to cross-sectional studies on the relationship between CAC and bone volume assessed invasively by bone biopsy, 1,2,5 one cross-sectional report using DXA of the spine in patients with CKD not on dialysis, 4 and a study showing a relationship between vascular calcifications and fractures. 37 An inverse relationship between CAC prevalence and BMD by DXA has also been shown in patients who are osteoporotic with normal kidney function and patients with HIV or metabolic syndrome.…”

Section: Discussionmentioning

confidence: 90%

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High Parathyroid Hormone Level and Osteoporosis Predict Progression of Coronary Artery Calcification in Patients on Dialysis

Malluche¹,

Blomquist²,

Monier‐Faugere³

et al. 2015

Journal of the American Society of Nephrology

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Coronary artery calcifications (CACs) are observed in most patients with CKD on dialysis (CKD-5D). CACs frequently progress and are associated with increased risk for cardiovascular events, the major cause of death in these patients. A link between bone and vascular calcification has been shown. This prospective study was designed to identify noninvasive tests for predicting CAC progression, including measurements of bone mineral density (BMD) and novel bone markers in adult patients with CKD-5D. At baseline and after 1 year, patients underwent routine blood tests and measurement of CAC, BMD, and novel serum bone markers. A total of 213 patients received baseline measurements, of whom about 80% had measurable CAC and almost 50% had CAC Agatston scores.400, conferring high risk for cardiovascular events. Independent positive predictors of baseline CAC included coronary artery disease, diabetes, dialysis vintage, fibroblast growth factor-23 concentration, and age, whereas BMD of the spine measured by quantitative computed tomography was an inverse predictor. Hypertension, HDL level, and smoking were not baseline predictors in these patients. Three quarters of 122 patients completing the study had CAC increases at 1 year. Independent risk factors for CAC progression were age, baseline total or whole parathyroid hormone level greater than nine times the normal value, and osteoporosis by t scores. Our results confirm a role for bone in CKD-associated CAC prevalence and progression.

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Section: Discussionmentioning

confidence: 90%

“…[1][2][3][4][5] Patients with CKD stages 4 and 5 have an annual mortality of 22.8%, 6 and cardiovascular disease is the cause of death in 60%-70% of patients with CKD-5D. 7 CACs have been found to be a strong predictor of cardiovascular disease, 8 are observed frequently, and progress rapidly in patients with CKD-5D.…”

mentioning

confidence: 99%

High Parathyroid Hormone Level and Osteoporosis Predict Progression of Coronary Artery Calcification in Patients on Dialysis

Malluche¹,

Blomquist²,

Monier‐Faugere³

et al. 2015

Journal of the American Society of Nephrology

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“…Increasing serum phosphate despite values within the normal range is associated with cardiovascular calcification and mortality in both non-CKD and CKD populations [1,22,23,24]. In CKD, decreased bone mass and low turnover bone disease are also associated with vascular calcification [2,18,25,26,27,28,29]. As mentioned earlier, bone loss as measured by a reduction in BMD is associated with the severity of arterial calcification.…”

Section: Discussionmentioning

confidence: 99%

Low Hip Bone Mineral Density Predicts Mortality in Maintenance Hemodialysis Patients: A Five-Year Follow-Up Study

Disthabanchong¹,

Jongjirasiri²,

Adirekkiat³

et al. 2014

Blood Purif

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Background: Bone loss is common among hemodialysis patients and contributes to mortality. The association between bone loss and vascular calcification may explain the increased mortality risk. Studies on the association between decreased bone mass and mortality in maintenance hemodialysis patients are limited. Methods: Eighty-three hemodialysis patients underwent bone mineral density (BMD) and coronary artery calcification (CAC) measurements. The relationship between BMD and mortality was analyzed after a 5-year follow-up period. Results: Eighty percent of the patients had reduced hip BMD. In univariate Cox regression analyses, age, cardiovascular disease, dyslipidemia, increased CAC score, increased comorbidity score and decreased hip BMD were associated with mortality. Low hip BMD remained independently associated with mortality after adjustments for cardiovascular risk factors, comorbidity score and CAC score. Patients with BMD in the lowest tertile had the worst survival. Conclusion: Low hip BMD predicted mortality in maintenance hemodialysis patients independent of CAC.

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“…The inverse relationship between bone density and coronary calcification has been described in several different clinical contexts, suggesting that plaque calcification and bone demineralization share common pathophysiological mechanisms. However, in other studies, associations between CCS and BMD were also not always maintained after adjustments to factors that could affect more CCS …”

Section: Discussionmentioning

confidence: 99%

Coronary artery calcium score in female rheumatoid arthritis patients: Associations with apolipoproteins and disease biomarkers

et al. 2019

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Aims and methods In rheumatoid arthritis (RA), cardiovascular (CV) comorbidities are a major cause of mortality. Coronary Calcium Score (CCS) assessed by computed tomography has been associated with RA prognosis. In this work, we aimed to assess CCS in female RA patients and determine CCS association with different clinical, laboratory and imaging disease parameters. Results We evaluated 60 female patients, with a mean age of 53.6 ± 10.4 years, a mean Disease Activity Score of 28 joints (DAS28) (4v) and Health Assessment Questionnaire (HAQ) of 4.542 ± 1.317 and 1.488 ± 0.631, respectively, and a disease duration of 14.7 ± 10.3 years. Mean CCS value was 35.192 ± 117.786. CCS > 10 was significantly associated with CV risk factors (age: odds ratio [OR] = 1.120; P = .002, body mass index [BMI] ≥ 25 kg/m2: OR = 0.271; P = .025, high‐density lipoprotein [HDL]: OR = 0.011; P = .025, low‐density lipoprotein/ HDL ratio: OR = 2.084; P = .030, apolipoprotein A1 [ApoA1]: OR = 0.965; P = .014, apolipoprotein B/ApoA1 [ApoB/ApoA1] ratio: OR = 59.834; P = .011, homocysteine: OR = 1.287; P = .045, diabetes: OR = 10.400; P = .043, and anti‐diabetic therapy: OR = 10.667, P = .041), disease parameters (C‐reactive protein [CRP]: OR = 1.038; P = .046, DAS[4v]: OR = 1.900; P = .009, DAS28[4v; CRP]: OR = 1.700; P = .019, DAS[3v]: OR = 1.947; P = .010, DAS28[3v; CRP]: OR = 1.696; P = .022, HAQ: OR = 3.299; P = .023, erosion score: OR = 1.015; P = .012, and total modified Sharp/van der Heijde Score: OR = 1.008; P = .035), biomarkers (osteoprotegerin: OR = 1.505; P = .022), and bone mineral density (femoral: OR = 0.005; P = .018, lumbar spine: OR = 0.001; P = .002, left hand: OR = 7.9 × 10−9; P = .005, and osteoporosis: OR = 6.628; P = .007). After adjustment for age and BMI, significant associations were maintained with ApoA1, ApoB/ApoA1 ratio, homocysteine, CRP, DAS(4v), DAS(4v; CRP), DAS(3v) and DAS(3v; CRP). A sensitivity analysis undertaken after excluding the 6 diabetics yielded similar results. Conclusions Our work reinforces the hypothesis that in RA, CCS may be a useful tool in CV risk assessment, particularly valuable in poorer controlled patients with certain lipoprotein profiles.

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Is Coronary Artery Calcification Associated with Vertebral Bone Density in Nondialyzed Chronic Kidney Disease Patients?

Cited by 20 publications

References 34 publications

High Parathyroid Hormone Level and Osteoporosis Predict Progression of Coronary Artery Calcification in Patients on Dialysis

High Parathyroid Hormone Level and Osteoporosis Predict Progression of Coronary Artery Calcification in Patients on Dialysis

Low Hip Bone Mineral Density Predicts Mortality in Maintenance Hemodialysis Patients: A Five-Year Follow-Up Study

Coronary artery calcium score in female rheumatoid arthritis patients: Associations with apolipoproteins and disease biomarkers

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